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Bajaj Allianz Health Ensure

Objective

An online health insurance policy which is aimed at including low segment individuals under the umbrella of insurance. The objective of this policy is to indemnify against expenses during hospitalisation caused due to illness or an accident.


Suited for

This is a low cost, low benefits policy suited for a low-income individual who wish to mitigate some part of, if not whole, medical expenses at a time of health urgency.


What does it do?

This policy sticks to providing a very basic cover against inpatient hospitalisation. Like any traditional health policy it covers all general expenses incurred during admission to hospital. Emergency ambulance to transfer patient from home or accidental site to hospital and back from hospital to home is also provided. Apart from inpatient treatment, it covers specific 130 such procedures not requiring a 24-hour hospitalisation due to technological upgradation. A free health check up can be availed at the end of four continuous claim-free years.


Pros

Family discount of 5 per cent is available.
Premium paid towards this policy is eligible for tax benefit under section 80D of Income Tax Act.


Cons

The policy offers a maximum cover of Rs 1 lakh only.
All benefits have a ceiling limit which means any expense beyond that limit will be denied.


Our View

This policy is specially meant for low income segment. It is low on premium and offers a stingy coverage. Though it may not be sufficient to cover all hospitalisation expenses, it can share a part of the losses.
In view of rising medical expenses now a days, everyone must have at least a basic health insurance policy plus a cover for chronic diseases. The cover can be stretched to include out patient treatments and other day to day expenses at time of hospitalisation. There are far more comprehensive policies available in the market which provide a broad and better immunity to medical costs. This policy is thus not recommended for those who can afford a better one as the cover may not suffice. Moreover, each expense is capped to sum insured which is another limitation.

Eligibility
Entry Age (years) 
Minimum18; 3 Months for Children
Maximum55
Maximum Policy Renewal Age (years)75
Coverage TypeIndividual Cover
Sum Insured (Rs) 
Maximum1 lakh
Minimum50000
Policy Term (years)1
Tax BenefitPremium paid is eligible for tax benefit under section 80D of the Income Tax Act
DiscountFamily discount of 5% is applicable
Pre Policy Medical Check UpNot required upto 55 years
Policy TerminationPolicyholder is allowed to terminate the policy at anytime by giving a 15 day written notice. In case no claim has been made under the policy, percentage of premium will be refunded
Customer Service 
AddressBajaj Allianz General Insurance Company Limited. GE Plaza, Airport Road, Yerawad, Pune - 411006
Mail to[email protected]
Call to1800 225858(BSNL/ MTNL); 1800 1025858 (Bharti users- mobile/ landline) or 020 30305858
Additions to the Plan
Scope Of Cover
Cashless facilityAvailable at empanelled hospitals in India
Re-imbursementIn case policyholder opts for non empaneled hosiptal , expenses are re-imbursed withing 14 working days from date of submission of all records.
Pre-post hospitalisation2% of admissible hospitalization expenses
Hospitalisation Expenses (Inpatient treatment)Covered
Room, Board & Nursing Expensesupto 1% Of Sum Insured per day*
ICU Expenseupto 2% Of Sum Insured per day*
*Room, board, nursing and ICU expenses can be taken upto maximum of 30% of Sum insured per illness/ injury
Surgeon, Anesthetist, Medical practitioner, Consultants, Specialist Fees upto 30% of Sum insured per illness/ injury
Emergency Ambulance charges up to Rs 1000/-, Anesthesia, Blood, Oxygen, operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs and any medical expenses incurred which is integral part of the operationupto 40% of Sum Insured per illness/ injury
Day Care Procedures130 day care procedures are covered
Emergency AmbulanceCovered; subject to maximum limit of Rs 1,000
Health Check UpCovered; at the end of 4 continuous claim free years
Exclusions & Waiting Period
Pre-existing disease2 years waiting period applicable for Pre-existing diseases
No claim periodAny disease contracted during the first 30 days of commencement of the policy
Waiting PeriodCertain diseases such as gastric / duodenal ulcers, Surgery of varicose veins/varicose ulcers etc shall be covered after a waiting period of 1 year and some diseases such as cataract, hernia etc. will be covered after a waiting period of 2 years.Certain diseases such as joint replacement surgery will have a waiting period of 4 years.
General exclusionsNon allopathic treatmentAIDS and other related diseases.Cosmetic, beauty, weight reduction and other likely treatments.Use of alcohol or other addictive substances.War, participation in any criminal activity or any other related condition.Treatmenmt of any mental or related disease.
Annual Premium Option for Metro Cities
Age (in years)Sum Insured (in Rs)
5000075000100000
3months- 256968951093
26-4074610071267
41-4595712901624
46-55151016242588
Indicative premiums for healthy individual; exclusive of service tax
Annual Premium Option for cities other than Metro Cities
Age (in years)Sum Insured (in Rs)
5000075000100000
3months- 256388211003
26-406849241163
41-4587811841490
46-55138518792374
Indicative premiums for healthy individual; exclusive of service tax

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